Clinical Resource Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Exhibit the organization's mission, vision, and values

• Provide competent care for assigned patients

• Conduct screening assessments on physician-assigned cases to evaluate medical necessity and status-determination requirements

• Reassess, monitor, and adapt transition needs as necessary

• Perform concurrent medical-record reviews utilizing established medical-necessity criteria to ascertain patients’ appropriate level of care

• Educate members of the healthcare team on regulatory-standard requirements

• Advocate for effective and efficient use of clinical resources throughout the care episode

• Act as a patient advocate

• Assist the physician in preparing Letters of Medical Necessity and Appeal Letters

• Build and sustain relationships with physicians, hospitals, patients, and ancillary medical professionals

• Engage in quality-assurance activities and audits

• Carry out related duties as assigned

⛳️ Requirements

• Must possess a valid Registered Nurse license in good standing

• State Board of Nursing License is required

• Preferably two to five years of experience with a proven record of success

• Experience in delivering customer service to both internal and external clients, including adherence to quality standards and assessment of customer satisfaction

• Basic proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint

• Ability to prioritize and manage multiple tasks and projects simultaneously

• Flexible scheduling and willingness to work overtime

• Strong attention to detail

• Capability to actively communicate, inspire, and motivate staff at all levels

• Ability to think and act strategically and proactively

• Proficient in maintaining accurate records and preparing reports and correspondence

• Skilled in organizing and coordinating the work of others

• Excellent verbal, written, communication, group presentation, and analytical skills

• Capacity to achieve and maintain proficiency in all necessary programs for execution

• Participate annually in mandatory legal and ethical compliance training

• Adhere to LUX Infusion’s legal, ethical, and compliance policies and Compliance Manual

• Avoid unethical or illegal behavior

• Ability to meet the physical demands of the role, including occasional lifting or moving of up to 25 pounds

🏝️ Benefits

• Purpose-driven work with tangible impact

• Patient-first, clinician-led culture

• Supportive and collaborative team environment

• Opportunity for growth within a company that is building something significant

• Reasonable accommodations available during the application or interview process